International orthopaedics
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The object of the present meta-analysis is to compare the effectiveness of transforaminal epidural steroid injection (TFESI) and interlaminar epidural steroid injection (ILESI) for treating patients with low back pain (LBP) secondary to lumbosacral radicular pain. ⋯ According to the results of meta-analysis, TFESI to manage LBP provides superior short term pain relief and equal functional improvement when compared to ILESI. It has not shown a statistically significant difference between both groups with regard to procedure frequency, surgery rate, and ventral epidural spread.
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The aim of this study was to evaluate the functional outcome of patients treated for a fracture of the capitulum humeri and to analyze the grade of osteoarthritic changes. ⋯ Level IV - Case series; therapeutic study.
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Open reductions and internal fixations are currently being used the most in surgeries of humeral shaft fractures. However, there are some limitations such as invasive techniques and formation of many operation scars. To overcome these limitations, a minimally invasive plate osteosynthesis has been recently introduced. However, this has technical limitations such as deep dissections of the distal portion and narrowness of the fixation space. To address these problems, we designed another introductory technique of a minimally invasive osteosynthesis and we have examined the clinical usefulness of that. ⋯ MIPOs using the dual approaches on the adult humerus shaft fracture show an excellent bony union without nerve injury which is clinically useful.
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To assess the technical feasibility, safety and initial clinical efficacy of a combined ultrasound and fluoroscopy imaging approach to cervical nerve root blocks. Fluoroscopic guided cervical transforaminal and selective nerve root injections are often used in the investigation or treatment of radicular symptoms, although rare but serious complications including death have been reported. We report a combined technique developed to increase safety of selective nerve root injections, including the safety and early efficacy of this novel technique in our initial patient cohort. ⋯ Using this combined image guided technique cervical nerve root blocks appear both safe and effective in the investigation and management of radicular symptoms from the cervical spine.
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Comparative Study
Comparative study suggests that human bone morphogenetic proteins have no influence on the outcome of operative treatment of aseptic clavicle non-unions.
The purpose of this study was to evaluate the clinical and radiological outcome following compression plate fixation in combination with autologous bone grafting, with and without additional application of recombinant human bone morphogenetic protein (rhBMP) for treatment of aseptic clavicle non-union. ⋯ Functional and radiological results demonstrate that successful healing of aseptic clavicle non-union is dependent on radical resection of non-union tissue, restoration of length of the shoulder girdle and application of stable locking-plate osteosynthesis in combination with autologous bone grafting, but not dependent on application of additional rhBMP.